Skip to main content
Erschienen in: Indian Journal of Surgical Oncology 2/2021

27.04.2021 | Review Article

Is Surgical Management of Primary Beneficial in Metastatic Breast Cancer??

verfasst von: Gaurav Patel, Bojja V Kishore Reddy, Prakash Patil

Erschienen in: Indian Journal of Surgical Oncology | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Metastatic breast cancer is not a curable disease, but women with metastatic disease are living longer. Although the relative survival has improved in recent years still patients who present with metastatic disease have a less than 30% 5-year survival. Historically, removal of the primary breast tumor has been offered to these patients only for palliation. However, there have been recent reports that removal of the primary tumor may improve survival. These are mostly retrospective studies limited by selection bias. Prospective and randomized trials have not shown a clear survival advantage. Although the definitive role of removal of the primary tumor in metastatic breast cancer is not settled, it is critical to understand the complexities of this debate in order to make further gains in breast cancer survivorship.
Literatur
1.
Zurück zum Zitat Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019 15;144(8):1941–53 Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019 15;144(8):1941–53
2.
Zurück zum Zitat Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424CrossRef Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424CrossRef
3.
Zurück zum Zitat Sant M, Allemani C, Berrino F, Coleman MP, Aareleid T, Chaplain G, Coebergh JW, Colonna M, Crosignani P, Danzon A, Federico M, Gafà L, Grosclaude P, Hédelin G, Macè-Lesech J, Garcia CM, Møller H, Paci E, Raverdy N, Tretarre B, Williams EMI, European Concerted Action on Survival and Care of Cancer Patients (EUROCARE) Working Group (2004 Feb 15) Breast carcinoma survival in Europe and the United States. Cancer. 100(4):715–722CrossRef Sant M, Allemani C, Berrino F, Coleman MP, Aareleid T, Chaplain G, Coebergh JW, Colonna M, Crosignani P, Danzon A, Federico M, Gafà L, Grosclaude P, Hédelin G, Macè-Lesech J, Garcia CM, Møller H, Paci E, Raverdy N, Tretarre B, Williams EMI, European Concerted Action on Survival and Care of Cancer Patients (EUROCARE) Working Group (2004 Feb 15) Breast carcinoma survival in Europe and the United States. Cancer. 100(4):715–722CrossRef
4.
Zurück zum Zitat Ly BH, Nguyen NP, Vinh-Hung V, Rapiti E, Vlastos G (2010 Feb) Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit? Breast Cancer Res Treat 119(3):537–545CrossRef Ly BH, Nguyen NP, Vinh-Hung V, Rapiti E, Vlastos G (2010 Feb) Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit? Breast Cancer Res Treat 119(3):537–545CrossRef
5.
Zurück zum Zitat Mariotto AB, Etzioni R, Hurlbert M, Penberthy L, Mayer M (2017) Estimation of the number of women living with metastatic breast Cancer in the United States. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 26(6):809–815CrossRef Mariotto AB, Etzioni R, Hurlbert M, Penberthy L, Mayer M (2017) Estimation of the number of women living with metastatic breast Cancer in the United States. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 26(6):809–815CrossRef
6.
Zurück zum Zitat Ruiterkamp J, Ernst MF, van de Poll-Franse LV, Bosscha K, Tjan-Heijnen VCG, Voogd AC (2009 Nov) Surgical resection of the primary tumour is associated with improved survival in patients with distant metastatic breast cancer at diagnosis. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 35(11):1146–1151 Ruiterkamp J, Ernst MF, van de Poll-Franse LV, Bosscha K, Tjan-Heijnen VCG, Voogd AC (2009 Nov) Surgical resection of the primary tumour is associated with improved survival in patients with distant metastatic breast cancer at diagnosis. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 35(11):1146–1151
7.
Zurück zum Zitat Thomas A, Khan SA, Chrischilles EA, Schroeder MC. Initial Surgery and Survival in Stage IV Breast Cancer in the United States, 1988–2011. JAMA Surg. 2016 01;151(5):424–31 Thomas A, Khan SA, Chrischilles EA, Schroeder MC. Initial Surgery and Survival in Stage IV Breast Cancer in the United States, 1988–2011. JAMA Surg. 2016 01;151(5):424–31
8.
Zurück zum Zitat Soran A, Ozbas S, Kelsey SF, Gulluoglu BM (2009 Aug) Randomized trial comparing locoregional resection of primary tumor with no surgery in stage IV breast cancer at the presentation (protocol MF07-01): a study of Turkish Federation of the National Societies for breast diseases. Breast J 15(4):399–403CrossRef Soran A, Ozbas S, Kelsey SF, Gulluoglu BM (2009 Aug) Randomized trial comparing locoregional resection of primary tumor with no surgery in stage IV breast cancer at the presentation (protocol MF07-01): a study of Turkish Federation of the National Societies for breast diseases. Breast J 15(4):399–403CrossRef
9.
Zurück zum Zitat Badwe R, Hawaldar R, Nair N, Kaushik R, Parmar V, Siddique S, Budrukkar A, Mittra I, Gupta S (2015 Oct) Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. Lancet Oncol 16(13):1380–1388CrossRef Badwe R, Hawaldar R, Nair N, Kaushik R, Parmar V, Siddique S, Budrukkar A, Mittra I, Gupta S (2015 Oct) Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. Lancet Oncol 16(13):1380–1388CrossRef
10.
Zurück zum Zitat Fisher B, Gunduz N, Coyle J, Rudock C, Saffer E (1989 Apr 15) Presence of a growth-stimulating factor in serum following primary tumor removal in mice. Cancer Res 49(8):1996–2001PubMed Fisher B, Gunduz N, Coyle J, Rudock C, Saffer E (1989 Apr 15) Presence of a growth-stimulating factor in serum following primary tumor removal in mice. Cancer Res 49(8):1996–2001PubMed
11.
Zurück zum Zitat Budd GT, Cristofanilli M, Ellis MJ, Stopeck A, Borden E, Miller MC, Matera J, Repollet M, Doyle GV, Terstappen LWMM, Hayes DF (2006 Nov 1) Circulating tumor cells versus imaging--predicting overall survival in metastatic breast cancer. Clin Cancer Res Off J Am Assoc Cancer Res 12(21):6403–6409CrossRef Budd GT, Cristofanilli M, Ellis MJ, Stopeck A, Borden E, Miller MC, Matera J, Repollet M, Doyle GV, Terstappen LWMM, Hayes DF (2006 Nov 1) Circulating tumor cells versus imaging--predicting overall survival in metastatic breast cancer. Clin Cancer Res Off J Am Assoc Cancer Res 12(21):6403–6409CrossRef
12.
Zurück zum Zitat Kakarala M, Wicha MS (2008 Jun 10) Implications of the cancer stem-cell hypothesis for breast cancer prevention and therapy. J Clin Oncol Off J Am Soc Clin Oncol 26(17):2813–2820CrossRef Kakarala M, Wicha MS (2008 Jun 10) Implications of the cancer stem-cell hypothesis for breast cancer prevention and therapy. J Clin Oncol Off J Am Soc Clin Oncol 26(17):2813–2820CrossRef
13.
Zurück zum Zitat Danna EA, Sinha P, Gilbert M, Clements VK, Pulaski BA, Ostrand-Rosenberg S (2004 Mar 15) Surgical removal of primary tumor reverses tumor-induced immunosuppression despite the presence of metastatic disease. Cancer Res 64(6):2205–2211CrossRef Danna EA, Sinha P, Gilbert M, Clements VK, Pulaski BA, Ostrand-Rosenberg S (2004 Mar 15) Surgical removal of primary tumor reverses tumor-induced immunosuppression despite the presence of metastatic disease. Cancer Res 64(6):2205–2211CrossRef
14.
Zurück zum Zitat Khan SA, Stewart AK, Morrow M (2002 Oct) Does aggressive local therapy improve survival in metastatic breast cancer? Surgery. 132(4):620–626 discussion 626-627 Khan SA, Stewart AK, Morrow M (2002 Oct) Does aggressive local therapy improve survival in metastatic breast cancer? Surgery. 132(4):620–626 discussion 626-627
15.
Zurück zum Zitat Babiera GV, Rao R, Feng L, Meric-Bernstam F, Kuerer HM, Singletary SE, Hunt KK, Ross MI, Gwyn KM, Feig BW, Ames FC, Hortobagyi GN (2006 Jun) Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol 13(6):776–782CrossRef Babiera GV, Rao R, Feng L, Meric-Bernstam F, Kuerer HM, Singletary SE, Hunt KK, Ross MI, Gwyn KM, Feig BW, Ames FC, Hortobagyi GN (2006 Jun) Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol 13(6):776–782CrossRef
16.
Zurück zum Zitat Dominici L, Najita J, Hughes M, Niland J, Marcom P, Wong Y-N, Carter B, Javid S, Edge S, Burstein H, Golshan M (2011 Sep) Surgery of the primary tumor does not improve survival in stage IV breast cancer. Breast Cancer Res Treat 129(2):459–465CrossRef Dominici L, Najita J, Hughes M, Niland J, Marcom P, Wong Y-N, Carter B, Javid S, Edge S, Burstein H, Golshan M (2011 Sep) Surgery of the primary tumor does not improve survival in stage IV breast cancer. Breast Cancer Res Treat 129(2):459–465CrossRef
17.
Zurück zum Zitat Lang JE, Tereffe W, Mitchell MP, Rao R, Feng L, Meric-Bernstam F, Bedrosian I, Kuerer HM, Hunt KK, Hortobagyi GN, Babiera GV (2013 Jun) Primary tumor extirpation in breast cancer patients who present with stage IV disease is associated with improved survival. Ann Surg Oncol 20(6):1893–1899CrossRef Lang JE, Tereffe W, Mitchell MP, Rao R, Feng L, Meric-Bernstam F, Bedrosian I, Kuerer HM, Hunt KK, Hortobagyi GN, Babiera GV (2013 Jun) Primary tumor extirpation in breast cancer patients who present with stage IV disease is associated with improved survival. Ann Surg Oncol 20(6):1893–1899CrossRef
18.
Zurück zum Zitat Lane WO, Thomas SM, Blitzblau RC, Plichta JK, Rosenberger LH, Fayanju OM, Hyslop T, Hwang ES, Greenup RA (2019) Surgical resection of the primary tumor in women with De novo stage IV breast Cancer: contemporary practice patterns and survival analysis. Ann Surg 269(3):537–544CrossRef Lane WO, Thomas SM, Blitzblau RC, Plichta JK, Rosenberger LH, Fayanju OM, Hyslop T, Hwang ES, Greenup RA (2019) Surgical resection of the primary tumor in women with De novo stage IV breast Cancer: contemporary practice patterns and survival analysis. Ann Surg 269(3):537–544CrossRef
19.
Zurück zum Zitat Bafford AC, Burstein HJ, Barkley CR, Smith BL, Lipsitz S, Iglehart JD, Winer EP, Golshan M (2009 May) Breast surgery in stage IV breast cancer: impact of staging and patient selection on overall survival. Breast Cancer Res Treat 115(1):7–12CrossRef Bafford AC, Burstein HJ, Barkley CR, Smith BL, Lipsitz S, Iglehart JD, Winer EP, Golshan M (2009 May) Breast surgery in stage IV breast cancer: impact of staging and patient selection on overall survival. Breast Cancer Res Treat 115(1):7–12CrossRef
20.
Zurück zum Zitat Blanchard DK, Shetty PB, Hilsenbeck SG, Elledge RM (2008 May) Association of surgery with improved survival in stage IV breast cancer patients. Ann Surg 247(5):732–738CrossRef Blanchard DK, Shetty PB, Hilsenbeck SG, Elledge RM (2008 May) Association of surgery with improved survival in stage IV breast cancer patients. Ann Surg 247(5):732–738CrossRef
21.
Zurück zum Zitat Fields RC, Jeffe DB, Trinkaus K, Zhang Q, Arthur C, Aft R, Dietz JR, Eberlein TJ, Gillanders WE, Margenthaler JA (2007 Dec) Surgical resection of the primary tumor is associated with increased long-term survival in patients with stage IV breast cancer after controlling for site of metastasis. Ann Surg Oncol 14(12):3345–3351CrossRef Fields RC, Jeffe DB, Trinkaus K, Zhang Q, Arthur C, Aft R, Dietz JR, Eberlein TJ, Gillanders WE, Margenthaler JA (2007 Dec) Surgical resection of the primary tumor is associated with increased long-term survival in patients with stage IV breast cancer after controlling for site of metastasis. Ann Surg Oncol 14(12):3345–3351CrossRef
22.
Zurück zum Zitat Gnerlich J, Jeffe DB, Deshpande AD, Beers C, Zander C, Margenthaler JA (2007 Aug) Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988-2003 SEER data. Ann Surg Oncol 14(8):2187–2194CrossRef Gnerlich J, Jeffe DB, Deshpande AD, Beers C, Zander C, Margenthaler JA (2007 Aug) Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988-2003 SEER data. Ann Surg Oncol 14(8):2187–2194CrossRef
23.
Zurück zum Zitat Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP, Chappuis PO, Bouchardy C (2006 Jun 20) Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol Off J Am Soc Clin Oncol 24(18):2743–2749CrossRef Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP, Chappuis PO, Bouchardy C (2006 Jun 20) Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol Off J Am Soc Clin Oncol 24(18):2743–2749CrossRef
24.
Zurück zum Zitat Rao R, Feng L, Kuerer HM, Singletary SE, Bedrosian I, Hunt KK, Ross MI, Hortobagyi GN, Feig BW, Ames FC, Babiera GV (2008 Jun) Timing of surgical intervention for the intact primary in stage IV breast cancer patients. Ann Surg Oncol 15(6):1696–1702CrossRef Rao R, Feng L, Kuerer HM, Singletary SE, Bedrosian I, Hunt KK, Ross MI, Hortobagyi GN, Feig BW, Ames FC, Babiera GV (2008 Jun) Timing of surgical intervention for the intact primary in stage IV breast cancer patients. Ann Surg Oncol 15(6):1696–1702CrossRef
25.
Zurück zum Zitat Vohra NA, Brinkley J, Kachare S, Muzaffar M (2018) Primary tumor resection in metastatic breast cancer: a propensity-matched analysis, 1988-2011 SEER data base. Breast J 24(4):549–554CrossRef Vohra NA, Brinkley J, Kachare S, Muzaffar M (2018) Primary tumor resection in metastatic breast cancer: a propensity-matched analysis, 1988-2011 SEER data base. Breast J 24(4):549–554CrossRef
26.
Zurück zum Zitat Dalberg K, Liedberg A, Johansson U, Rutqvist LE (2003 Mar) Uncontrolled local disease after salvage treatment for ipsilateral breast tumour recurrence. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 29(2):143–154 Dalberg K, Liedberg A, Johansson U, Rutqvist LE (2003 Mar) Uncontrolled local disease after salvage treatment for ipsilateral breast tumour recurrence. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 29(2):143–154
27.
Zurück zum Zitat King TA, Lyman JP, Gonen M, Voci A, De Brot M, Boafo C, et al. Prognostic Impact of 21-Gene Recurrence Score in Patients With Stage IV Breast Cancer: TBCRC 013. J Clin Oncol Off J Am Soc Clin Oncol. 2016 10;34(20):2359–65 King TA, Lyman JP, Gonen M, Voci A, De Brot M, Boafo C, et al. Prognostic Impact of 21-Gene Recurrence Score in Patients With Stage IV Breast Cancer: TBCRC 013. J Clin Oncol Off J Am Soc Clin Oncol. 2016 10;34(20):2359–65
28.
Zurück zum Zitat Soran A, Ozmen V, Ozbas S, Karanlik H, Muslumanoglu M, Igci A, Canturk Z, Utkan Z, Ozaslan C, Evrensel T, Uras C, Aksaz E, Soyder A, Ugurlu U, Col C, Cabioglu N, Bozkurt B, Uzunkoy A, Koksal N, Gulluoglu BM, Unal B, Atalay C, Yıldırım E, Erdem E, Salimoglu S, Sezer A, Koyuncu A, Gurleyik G, Alagol H, Ulufi N, Berberoglu U, Dulger M, Cengiz O, Sezgin E, Johnson R (2018 Oct) Randomized trial comparing resection of primary tumor with no surgery in stage IV breast Cancer at presentation: protocol MF07-01. Ann Surg Oncol 25(11):3141–3149CrossRef Soran A, Ozmen V, Ozbas S, Karanlik H, Muslumanoglu M, Igci A, Canturk Z, Utkan Z, Ozaslan C, Evrensel T, Uras C, Aksaz E, Soyder A, Ugurlu U, Col C, Cabioglu N, Bozkurt B, Uzunkoy A, Koksal N, Gulluoglu BM, Unal B, Atalay C, Yıldırım E, Erdem E, Salimoglu S, Sezer A, Koyuncu A, Gurleyik G, Alagol H, Ulufi N, Berberoglu U, Dulger M, Cengiz O, Sezgin E, Johnson R (2018 Oct) Randomized trial comparing resection of primary tumor with no surgery in stage IV breast Cancer at presentation: protocol MF07-01. Ann Surg Oncol 25(11):3141–3149CrossRef
29.
Zurück zum Zitat Fitzal F, Bjelic-Radisic V, Knauer M, Steger G, Hubalek M, Balic M, Singer C, Bartsch R, Schrenk P, Soelkner L, Greil R, Gnant M, ABCSG. (2019) Impact of breast surgery in primary metastasized breast Cancer: outcomes of the prospective randomized phase III ABCSG-28 POSYTIVE trial. Ann Surg 269(6):1163–1169CrossRef Fitzal F, Bjelic-Radisic V, Knauer M, Steger G, Hubalek M, Balic M, Singer C, Bartsch R, Schrenk P, Soelkner L, Greil R, Gnant M, ABCSG. (2019) Impact of breast surgery in primary metastasized breast Cancer: outcomes of the prospective randomized phase III ABCSG-28 POSYTIVE trial. Ann Surg 269(6):1163–1169CrossRef
30.
Zurück zum Zitat AlJohani B, AlMalik O, Anwar E, Tulbah A, Alshabanah M, AlSyaed A, Ajarim D, ALTweigeri T (2016 Nov) Impact of surgery on survival in stage IV breast Cancer. Breast J 22(6):678–682CrossRef AlJohani B, AlMalik O, Anwar E, Tulbah A, Alshabanah M, AlSyaed A, Ajarim D, ALTweigeri T (2016 Nov) Impact of surgery on survival in stage IV breast Cancer. Breast J 22(6):678–682CrossRef
31.
Zurück zum Zitat Harris E, Barry M, Kell MR (2013 Sep) Meta-analysis to determine if surgical resection of the primary tumour in the setting of stage IV breast cancer impacts on survival. Ann Surg Oncol 20(9):2828–2834CrossRef Harris E, Barry M, Kell MR (2013 Sep) Meta-analysis to determine if surgical resection of the primary tumour in the setting of stage IV breast cancer impacts on survival. Ann Surg Oncol 20(9):2828–2834CrossRef
32.
Zurück zum Zitat Somsekhar SP, Geeta K, Jain R, Nayyer R, Halder S, Malik VK, Parikh P, Aggarwal S, Koul R (2018) Practical consensus recommendations regarding role of mastectomy in metastatic breast cancer. South Asian J Cancer 7(2):79–82CrossRef Somsekhar SP, Geeta K, Jain R, Nayyer R, Halder S, Malik VK, Parikh P, Aggarwal S, Koul R (2018) Practical consensus recommendations regarding role of mastectomy in metastatic breast cancer. South Asian J Cancer 7(2):79–82CrossRef
Metadaten
Titel
Is Surgical Management of Primary Beneficial in Metastatic Breast Cancer??
verfasst von
Gaurav Patel
Bojja V Kishore Reddy
Prakash Patil
Publikationsdatum
27.04.2021
Verlag
Springer India
Erschienen in
Indian Journal of Surgical Oncology / Ausgabe 2/2021
Print ISSN: 0975-7651
Elektronische ISSN: 0976-6952
DOI
https://doi.org/10.1007/s13193-021-01329-1

Weitere Artikel der Ausgabe 2/2021

Indian Journal of Surgical Oncology 2/2021 Zur Ausgabe

Desk of the Editor

Editorial

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.